Demographic challenges for Bangladesh

Elderly people are now living longer, which means that they are more susceptible to chronic health problems, which may demand long term treatment, hospitalisation and nursing

In Bangladesh the number of people over 60 years is increasing rapidly. Both the absolute number of elders and their percentage in total population are rising sharply. These aged people expect much more social security and especially health care. However, the magnitude of the elderly population’s health in Bangladesh has been remaining relatively neglected. Since Bangladesh does not have a social welfare system, there is lack of social services like old age benefits, healthcare, shelters, and subsidized services. De facto lack of social safety net, there has been quick deterioration of both health and economic condition of elderly population. Moreover, familial support for caring about the elderly has been reducing due to lack of economic solvency, nuclear family, isolate living and losing bond among the members. Social and cultural transformations along with the economic hardship are creating serious threat to the elderly support system of Bangladesh. Thus most of the older people in the country are suffering from lack of sufficient income and employment opportunities, absolute poverty, geriatric diseases and absence of proper health and Medicare facilities, exclusion, negligence, deprivation, socio--economic insecurity and elder abuse. The elder population boom should be seen as an emerging challenge. However, it is observed that very few initiatives have been taken so far for the welfare of the elderly people.
Elderly population in the context of Bangladesh has been defined as those who have reached 60 years of age. However, people in this country become older earlier because of poverty and the situations related to hard labor, malnutrition, illness and geographical condition. The enormous bump up elder population aged 60 years and above in different years is shown in the following figures:

As evident from the figure-1, elderly population has increased from 2.2 million in 1950 to about 11.3 million in 2016 and projected to exceed 54 million in 2061. Bangladesh will face alarming socioeconomic challenges shouldering huge responsibilities of 65.1 million (6.5 crore) elder population in 2085. It is anticipated that elderly population will slightly reduce along with total population in 2100. In terms of percentage, elderly population has increased slowly from 6 per cent in 1950 to nearly 8 per cent in 2016. It is estimated that there will be abrupt growth of elderly population in subsequent years and shoot up 37  per cent by 2100. Rapid growth of elderly population relative to other age groups will terribly challenge existing health services, family supports and social security.
The median age of a population is that age dividing a population into two groups of the equal size, half the population is above this age and half are below. The median age is considered as strongest indicator of population is ageing.

The median age of population in Bangladesh increased gradually from 19.3 in 1950 to 25.6 in 2015. During the subsequent year, population aging is projected to be much faster and the median age will shoot up 49 years in 21st century. That is 50 per cent of population will be aged more than 49 years.
The ageing index is another indicator of population ageing. It is calculated as the number of persons 60 years old or over per hundred persons under age 15. The ageing index in Bangladesh has slowly increased over last 50 years from 14 in 1950 to 16 in 2000. However, it is projected to rapidly increase 8 folds during the next 50 years and shoot up 125 by 2050. The ageing index in Bangladesh will continue to soar and estimated to rise 261 in 2100.

There has been significant demographic transition of population in Bangladesh forming quite different age structure. In the past, younger population under 15 years dominated because of high fertility in the past. The causes of radical transformation in population age structure are significant reduction of total fertility (average number of children per woman), sharp decline in infant and child mortality rate and consequent increase in life expectancy at birth.

There were 35-37 million births during high population growth in 1950s and 1960s. The large number of babies born during the 1950s and 1960s have been growing up and beginning to have dramatic effect on the ageing situation in Bangladesh. The number of elderly people is going to surpass the number of children and sales of adult diapers will shortly surpass diapers for babies. This change in the demographic makeup of Bangladeshi society, referred to as population aging will take place in a shorter span of time than in many countries.

According to the latest WHO data published in 2015 life expectancy in Bangladesh is: Male 70.6, female 73.1 and total life expectancy is 71.8. There has been very impressive increase of life expectancy in Bangladesh. The average life expectancy in Bangladesh has shot up from 46 years in 1960 to 73 years in 2015-20 and it is predicted to keep on soaring in future. The estimated average life expectancy in Bangladesh will increase to 85 years in 2095-2100. Life expectancy at birth summarizes the mortality at all ages. Nevertheless, it is not a measure of overall quality of life. People in Bangladesh can now expect to live longer than ever before, but disability, insolvency, chronic diseases and lack of care may jeopardize their longevity. Even the rich countries are finding difficult to keep the elderly alive with tons of medication & wearing diapers. If so, how the severely resource starve country like Bangladesh will overcome this emerging challenges due to elder population boom?

There has been enormous increase of elder population aged 100 years and above. There was insignificant number of extremely elder population aged 100 years and above in the past and it is estimated to increase slowly over one century to 1.13 million by 2050. During four decades from 2060 to 2100, extremely elder population is predicted to rocket nearly eleven folds. The estimated number of extremely elder population aged 100 years & above will rapidly increase to 12.64 million (one crore & 26 lac) in 21st century.

There was only 30 thousand elder population aged 75 years and above in 1950 and increased slowly to 1.4 million by 2000. It is predicted to keep on soaring faster in future. The number of elder population aged 75 years and above in Bangladesh will shoot-up during the subsequent years. The estimated number of elder population aged 75 years will increase to 32.3 million (3 crore & 23 lac) in 2100.

The total dependency ratio is the number of persons under age 15 plus persons aged 60 or older per one hundred persons 15 to 59. It is the sum of the youth dependency ratio and the old-age dependency ratio. The youth dependency ratio ((YDR) is the number of persons 0 to 14 years per one hundred persons 15 to 59 years. The old-age dependency ratio (ODR) is the number of persons 60 years and over per one hundred persons 15 to 59 years.

Support Index is ratio of the population age 15-59 years to the population 60 years and above. There has been decrease in support index and it will continue to shrink further. Support index will be declining from about 9 in 2001 to 3 in 2051. That is 3 persons in the working age group will have to support one person in old age compared to 9 persons in 2001. By 2100, the potential support ratio is projected to drop further to 1.3 potential workers per older person.
Care index refers to number of people of advanced old age (70 years where the need for care is most prevalent) per 100 people in the age group 40-59 younger than they are, who normally take responsibility for caring for the elderly.
Demographic transition will affect from 2016. The effects of these changes, however, would be even more enormous and serious in the future. One hundred younger people aged 40-59 years will shoulder the responsibility of nearly 13 advanced old age persons in 2016. The care index will be nearly 33 per cent that is nearly triple in 2051. This demonstrates 0 younger people aged 40-59 years will shoulder one advanced old age persons having greater need for care and support due to physical weakness, disability and susceptibility to chronic diseases.

Due to elder population boom and their physical weakness, disability and susceptibility to chronic diseases, old people are very much dependent traditionally on family members. However, there has been significant reduction of care and support from the family members due to demographic transition, socio-economic transformation, industrialization, urbanization, nuclear family, isolate living and losing bond among the members.
Elderly people are now living longer, which means that they are more susceptible to chronic health problems, which may demand long term treatment, hospitalization and nursing care. In future, older people will be the major users of health services. There will be a growing demand for care related to conditions such as cardiovascular disease, cancer, chronic obstructive pulmonary disease, arthritis, vision impairment and disability. Elderly people suffer from multiple health problems.

Population ageing is already having major consequences and implications in all areas of life, and will continue to do so. In the economic area, population ageing will affect economic growth, savings, investment and consumption, labour markets, pensions, taxation and the transfer of wealth, property and care from one generation to another. Furthermore, most of them are seriously suffering from some basic human needs-related challenges, viz. lack of minimum income and employment opportunities, extreme poverty. There is also lack of proper health/medical care, food and nutrition and living arrangements. Elderly people are often victim of isolation, exclusion, loneliness and negligence. Consequently there has been increasing psychosocial and cultural complexities.

     The writer is a doctor

Demographic challenges for Bangladesh

Elderly people are now living longer, which means that they are more susceptible to chronic health problems, which may demand long term treatment, hospitalisation and nursing

In Bangladesh the number of people over 60 years is increasing rapidly. Both the absolute number of elders and their percentage in total population are rising sharply. These aged people expect much more social security and especially health care. However, the magnitude of the elderly populations health in Bangladesh has been remaining relatively neglected. Since Bangladesh does not have a social welfare system, there is lack of social services like old age benefits, healthcare, shelters, and subsidized services. De facto lack of social safety net, there has been quick deterioration of both health and economic condition of elderly population. Moreover, familial support for caring about the elderly has been reducing due to lack of economic solvency, nuclear family, isolate living and losing bond among the members. Social and cultural transformations along with the economic hardship are creating serious threat to the elderly support system of Bangladesh. Thus most of the older people in the country are suffering from lack of sufficient income and employment opportunities, absolute poverty, geriatric diseases and absence of proper health and Medicare facilities, exclusion, negligence, deprivation, socio--economic insecurity and elder abuse. The elder population boom should be seen as an emerging challenge. However, it is observed that very few initiatives have been taken so far for the welfare of the elderly people. Elderly population in the context of Bangladesh has been defined as those who have reached 60 years of age. However, people in this country become older earlier because of poverty and the situations related to hard labor, malnutrition, illness and geographical condition. The enormous bump up elder population aged 60 years and above in different years is shown in the following figures: As evident from the figure-1, elderly population has increased from 2.2 million in 1950 to about 11.3 million in 2016 and projected to exceed 54 million in 2061. Bangladesh will face alarming socioeconomic challenges shouldering huge responsibilities of 65.1 million (6.5 crore) elder population in 2085. It is anticipated that elderly population will slightly reduce along with total population in 2100. In terms of percentage, elderly population has increased slowly from 6 per cent in 1950 to nearly 8 per cent in 2016. It is estimated that there will be abrupt growth of elderly population in subsequent years and shoot up 37 per cent by 2100. Rapid growth of elderly population relative to other age groups will terribly challenge existing health services, family supports and social security. The median age of a population is that age dividing a population into two groups of the equal size, half the population is above this age and half are below. The median age is considered as strongest indicator of population is ageing. The median age of population in Bangladesh increased gradually from 19.3 in 1950 to 25.6 in 2015. During the subsequent year, population aging is projected to be much faster and the median age will shoot up 49 years in 21st century. That is 50 per cent of population will be aged more than 49 years. The ageing index is another indicator of population ageing. It is calculated as the number of persons 60 years old or over per hundred persons under age 15. The ageing index in Bangladesh has slowly increased over last 50 years from 14 in 1950 to 16 in 2000. However, it is projected to rapidly increase 8 folds during the next 50 years and shoot up 125 by 2050. The ageing index in Bangladesh will continue to soar and estimated to rise 261 in 2100. There has been significant demographic transition of population in Bangladesh forming quite different age structure. In the past, younger population under 15 years dominated because of high fertility in the past. The causes of radical transformation in population age structure are significant reduction of total fertility (average number of children per woman), sharp decline in infant and child mortality rate and consequent increase in life expectancy at birth. There were 35-37 million births during high population growth in 1950s and 1960s. The large number of babies born during the 1950s and 1960s have been growing up and beginning to have dramatic effect on the ageing situation in Bangladesh. The number of elderly people is going to surpass the number of children and sales of adult diapers will shortly surpass diapers for babies. This change in the demographic makeup of Bangladeshi society, referred to as population aging will take place in a shorter span of time than in many countries. According to the latest WHO data published in 2015 life expectancy in Bangladesh is: Male 70.6, female 73.1 and total life expectancy is 71.8. There has been very impressive increase of life expectancy in Bangladesh. The average life expectancy in Bangladesh has shot up from 46 years in 1960 to 73 years in 2015-20 and it is predicted to keep on soaring in future. The estimated average life expectancy in Bangladesh will increase to 85 years in 2095-2100. Life expectancy at birth summarizes the mortality at all ages. Nevertheless, it is not a measure of overall quality of life. People in Bangladesh can now expect to live longer than ever before, but disability, insolvency, chronic diseases and lack of care may jeopardize their longevity. Even the rich countries are finding difficult to keep the elderly alive with tons of medication wearing diapers. If so, how the severely resource starve country like Bangladesh will overcome this emerging challenges due to elder population boom? There has been enormous increase of elder population aged 100 years and above. There was insignificant number of extremely elder population aged 100 years and above in the past and it is estimated to increase slowly over one century to 1.13 million by 2050. During four decades from 2060 to 2100, extremely elder population is predicted to rocket nearly eleven folds. The estimated number of extremely elder population aged 100 years above will rapidly increase to 12.64 million (one crore 26 lac) in 21st century. There was only 30 thousand elder population aged 75 years and above in 1950 and increased slowly to 1.4 million by 2000. It is predicted to keep on soaring faster in future. The number of elder population aged 75 years and above in Bangladesh will shoot-up during the subsequent years. The estimated number of elder population aged 75 years will increase to 32.3 million (3 crore 23 lac) in 2100. The total dependency ratio is the number of persons under age 15 plus persons aged 60 or older per one hundred persons 15 to 59. It is the sum of the youth dependency ratio and the old-age dependency ratio. The youth dependency ratio ((YDR) is the number of persons 0 to 14 years per one hundred persons 15 to 59 years. The old-age dependency ratio (ODR) is the number of persons 60 years and over per one hundred persons 15 to 59 years. Support Index is ratio of the population age 15-59 years to the population 60 years and above. There has been decrease in support index and it will continue to shrink further. Support index will be declining from about 9 in 2001 to 3 in 2051. That is 3 persons in the working age group will have to support one person in old age compared to 9 persons in 2001. By 2100, the potential support ratio is projected to drop further to 1.3 potential workers per older person. Care index refers to number of people of advanced old age (70 years where the need for care is most prevalent) per 100 people in the age group 40-59 younger than they are, who normally take responsibility for caring for the elderly. Demographic transition will affect from 2016. The effects of these changes, however, would be even more enormous and serious in the future. One hundred younger people aged 40-59 years will shoulder the responsibility of nearly 13 advanced old age persons in 2016. The care index will be nearly 33 per cent that is nearly triple in 2051. This demonstrates 0 younger people aged 40-59 years will shoulder one advanced old age persons having greater need for care and support due to physical weakness, disability and susceptibility to chronic diseases. Due to elder population boom and their physical weakness, disability and susceptibility to chronic diseases, old people are very much dependent traditionally on family members. However, there has been significant reduction of care and support from the family members due to demographic transition, socio-economic transformation, industrialization, urbanization, nuclear family, isolate living and losing bond among the members. Elderly people are now living longer, which means that they are more susceptible to chronic health problems, which may demand long term treatment, hospitalization and nursing care. In future, older people will be the major users of health services. There will be a growing demand for care related to conditions such as cardiovascular disease, cancer, chronic obstructive pulmonary disease, arthritis, vision impairment and disability. Elderly people suffer from multiple health problems. Population ageing is already having major consequences and implications in all areas of life, and will continue to do so. In the economic area, population ageing will affect economic growth, savings, investment and consumption, labour markets, pensions, taxation and the transfer of wealth, property and care from one generation to another. Furthermore, most of them are seriously suffering from some basic human needs-related challenges, viz. lack of minimum income and employment opportunities, extreme poverty. There is also lack of proper health/medical care, food and nutrition and living arrangements. Elderly people are often victim of isolation, exclusion, loneliness and negligence. Consequently there has been increasing psychosocial and cultural complexities. The writer is a doctor